scholarly journals Rare Case of a Solitary Bone Plasmacytoma of the Proximal Femur Managed with Surgery and Adjuvant Chemotherapy: A Case Report

2021 ◽  
Vol 11 (5) ◽  
Author(s):  
Rudra M Prabhu ◽  
Swapnil A Keny
Keyword(s):  
Multiple Myeloma ◽  
Case Report ◽  
Adjuvant Chemotherapy ◽  
Proximal Femur ◽  
Femur Fracture ◽  
Myeloma Protein ◽  
Rare Neoplasm ◽  
Solitary Bone Plasmacytoma ◽  
The Right ◽  
Subtrochanteric Femur Fracture

Introduction: Solitary plasmacytoma of the bone is a rare neoplasm characterized by proliferation of neoplastic plasma cells in the bone in the absence of systemic involvement. We present a managed case of a 64-year-old male with solitary bone plasmacytoma of the right proximal femur, who presented as a pathological subtrochanteric femur fracture. Case Report: A 64-year-old male presented to our outpatient department with pain in the right hip and restricted range of motion following a trivial trauma. The radiographs showed an osteolytic lesion in the right proximal femur with a right subtrochanteric femur fracture. A magnetic resonance imaging scan revealed a well-defined lesion in the right proximal femur. A 18F-fluorodeoxyglucose positron emission tomography did not show a lesion at any other site suggesting that the lesion was solitary. A serum protein electrophoresis study was normal and the urine was negative for myeloma protein. The patient had a score of 12 as per Mirel’s criteria and hence required operative intervention and fixation. The patient was managed with a thorough mechanical and chemical curettage of the lesion followed by fixation with a proximal femur locking plate and augmentation with fibula and iliac crest bone graft. He was then given a chemotherapy regimen consisting of nine cycles of bortezomib, lenalidomide, and dexamethasone. Conclusion: Solitary bone plasmacytoma is a rare neoplasm of the bone. Early diagnosis and intervention are required to manage it and prevent its progression to multiple myeloma, which is a more aggressive entity and lies at the other end of the spectrum of plasma cell dyscrasias. Management of this lesion requires an active participation of the hematologist and a holistic approach which includes radiotherapy or surgery with possible adjuvant chemotherapy. Keywords: Solitary bone plasmacytoma, subtrochanteric femur fracture, multiple myeloma, bortezomib, lenalidomide, dexamethasone.

scholarly journals Abducens Nerve Palsy as Initial Presentation of Multiple Myeloma and Intracranial Plasmacytoma

2018 ◽  
Vol 7 (9) ◽  
pp. 253
Author(s):  
Elochukwu Ibekwe ◽  
Neil Horsley ◽  
Lan Jiang ◽  
Nadine-Stella Achenjang ◽  
Azubuogu Anudu ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Multiple Myeloma ◽  
Nervous System ◽  
Case Report ◽  
Nerve Palsy ◽  
Abducens Nerve ◽  
Initial Presentation ◽  
Solitary Plasmacytoma ◽  
Cns Involvement ◽  
The Right

Central Nervous System (CNS) involvement in multiple myeloma and/or multifocal solitary plasmacytoma is rare. Although they are unique entities, multiple myeloma (MM) and plasmacytoma represent a spectrum of plasma cell neoplastic diseases that can sometimes occur concurrently. Plasmacytomas very often present as late-stage sequelae of MM. In this case report, we report a 53-year-old female presenting with right abducens cranial nerve (CN) VI palsy as an initial presentation secondary to lesion of the right clivus.

scholarly journals Reverse distal femoral locking plate for subtrochanter femur fracture

2018 ◽  
Vol 27 (2) ◽  
Author(s):  
Peter Giarso ◽  
Ismail H. Dilogo
Keyword(s):  
Distal Femur ◽  
Locking Plate ◽  
Femur Fracture ◽  
Case Series ◽  
Subtrochanteric Fracture ◽  
Locking Compression Plate ◽  
Non Union ◽  
Functional Scores ◽  
The Right ◽  
Subtrochanteric Femur Fracture

In these case series, we used titanium locking compression plate-distal femur (LCP-DF) plate (Synthes) 9–11 hole using less invasive stabilization system or open reduction technique. This case series aims to determine the functional scores on reverse distal femoral locking plate for subtrochanteric femur fracture. A 34-year-old male with closed subtrochanteric fracture of the right femur (Seinsheimer 2B) with Harris hip scores (HHS) of 17, 96, and 97 obtained consecutively in 0, 6, and 12 months, respectively. A 24-year-old male with closed comminuted subtrochanteric fracture of the right femur (Seinsheimer V) with HHS of 13, 93, and 97 at 0, 6, and 12 months respectively. A 39-year-old male with non-union, left subtrochanteric femur fracture (Seinsheimer 2C) yielded HHS of 38, 73, and 77 at 0, 6, and 12 months, respectively. A 35-year-old female with close subtrochanteric fracture of the right femur (Seinsheimer IIB) yielded HHS of 23, 40, and 73 at 0, 6, and 12 months, respectively. Mean initial HHS and scores at 6 and 12 months reached 22, 75, and 86, respectively.

scholarly journals Congenital Insensitivity to Pain and Anhidrosis: A painful experience by a painless child

2021 ◽  
Vol 4 (1) ◽  
pp. 4-7
Author(s):  
Sia Ung ◽  
◽  
Zulkiflee Bin Osman ◽  
Nur Syahida Binti Mohd Termizi ◽  
Mohd Firdaus Hafni Bin Ahmad ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Femur Fracture ◽  
Hip Dislocation ◽  
Distal Humerus ◽  
Congenital Insensitivity ◽  
Congenital Insensitivity To Pain ◽  
Elastic Nail ◽  
The Right ◽  
Subtrochanteric Femur Fracture ◽  
Insensitivity To Pain

A three-year-old boy with congenital insensitivity to pain and anhidrosis (CIPA) was first presented with transphyseal separation of distal left humerus. Surgical treatment with closed reduction and k-wiring of transphyseal separation of distal humerus resulted in devastating surgical site infection and osteomyelitis. Multiple surgical debridement and application of external fixator to eliminate infection were futile. At the age of four years, he refused to bear weight as a result of left hip dislocation. Closed reduction and spica cast was unsuccessful, resulting in recurrent left hip dislocation. He has since not been able to walk. At the age of five years, the right hip was dislocated followed by ipsilateral subtrochanteric femur fracture. Appropriate treatments such as hip spica and titanium elastic nail were not possible due to extensive bruising and skin ulceration over the right thigh. This child ended up with a functionless left upper limb, bilateral hip dislocation and malunited right femur fracture. Conservative treatment and watchful neglect might be the ideal treatment for patients with CIPA.

scholarly journals A CASE REPORT OF FEMUR OSTEOCHONDROMA IN 22 YEARS OLD FEMALE PATIENT

2020 ◽  
Vol 8 (10) ◽  
pp. 1263-1267
Author(s):  
Abdulrahman M. Bin Mohi ◽  
◽  
Ahmed A. Alzahrani ◽  
Bashar R. Reda
Keyword(s):  
Case Report ◽  
Female Patient ◽  
Proximal Femur ◽  
Conflict Of Interest ◽  
Distal Femur ◽  
Tumor Resection ◽  
Surgical Excision ◽  
Low Grade ◽  
The Right ◽  
Hands And Feet

Chondromais considered a nonmalignant tumor that composed of mature hyaline cartilage and commonly occur in hands and feet. Overall incidents show that females are predominant comparing to males with evenly distributed range of ages. Multiple chondromas have to be differentiated from osteochondroma and chondrosarcoma. This paper reports three different types of lesions in one patient.Osteochondroma or exostosis is the most common benign tumor of the skeleton. It is a developmental osseous anomaly, which arises from exophytic outgrowth on bone surfaces characteristically. Osteochondroma account for about 12% of bone tumors. Here, we have described a 22 years old female patient with left knee joint pain and swelling of the left distal femur with limited movements. The incisional biopsy of the left distal femur identified low-grade chondrosarcoma and chondroma after histopathology. This underwent one-stage surgical excision of the tumor with a posterior approach and tumor resection from the femur. After surgery, an unusual pain appears in the right hip joint during the post-operative period.Machine resonance imaging (MRI), and X-ray of pelvis help to diagnose thewell-differentiated chondrosarcoma and chondroma. This was a case of osteochondroma in the right proximal femur, chondroma like lesion in the left proximal femur and chondrosarcoma in the left distal femur. Ethical consideration: Written informed consent was obtained from the patient for publication of this case report and accompanying images. Conflict of interest: There is no conflict of interest.

scholarly journals Bilateral Periprosthetic Knee Fracture with the Right Floating Total Knee and Left Periprosthetic Patella Fracture Management Strategy: A Case Report

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lavindra Tomar ◽  
Gaurav Govil ◽  
Pawan Dhawan
Keyword(s):  
Case Report ◽  
Management Strategy ◽  
Knee Injury ◽  
Distal Femur ◽  
Femur Fracture ◽  
Left Knee ◽  
Patellar Fracture ◽  
Distal Femur Fracture ◽  
Total Knee ◽  
The Right

Introduction: Periprosthetic fractures (PPFs) in total knee replacement are an uncommon condition. The floating knee injury around total knee arthroplasty (TKA) is even rare and poses challenges in management. Incidence is increasing due to growing primary joint arthroplasties and revision procedures. We report a case of bilateral PPF with a floating total knee. Case Report: A 74-year-old female involved in a violent car accident sustained bilateral knee injuries, facial, and hand injury. In the emergency room, the initial resuscitation and trauma protocol stabilization were done and she was provisionally immobilized for her limb injuries. She presented with the right-sided floating total knee involving periprosthetic periarticular comminuted distal femur fracture and midshaft comminuted fracture tibia fibula. The patient also had left knee lower pole periprosthetic patellar fracture. The patient had a history of bilateral TKA around 2 years back. She underwent surgical management of the right floating total knee by stabilization of distal femur fracture and tibial shaft fracture fixation with locking plates. She underwent primary autologous bone grafting for both fracture sites. The left knee patellar fracture was managed conservatively in a brace. At 8 months follow-up, the patient was pain free and had consolidation of fractures. The patient walked without any walking aids. At 18 months, she had regained her pre-injury functional status. Conclusion: Each fracture in a floating total knee injury is unique and treatment should be decided based on individual analysis and the extent of soft-tissue injuries. An uncommon occurrence highlights the complex injury patterns involving PPF requiring individualized case specific management strategy. Keywords: Floating total knee, Periprosthetic knee fracture, floating knee.

scholarly journals Bilateral Primary Aneurysmal Bone Cyst of Proximal Femur: A Rare Case Report

2021 ◽  
pp. 217-223
Author(s):  
Sudhir Shyam Kushwaha ◽  
Kumar Shantanu ◽  
Garima Maurya ◽  
Abhishek Pandey
Keyword(s):  
Case Report ◽  
Proximal Femur ◽  
Rare Case ◽  
Pathological Fracture ◽  
English Literature ◽  
Bone Cyst ◽  
Open Biopsy ◽  
Rare Case Report ◽  
Aneurysmal Bone Cysts ◽  
The Right

Aneurysmal bone cysts (ABC) are blood-filled, locally destructive, expansile lesions of the bone. ABC of the proximal femur is usually unilateral in presentation. As far as the English literature is concerned, there is no case report of bilateral involvement of the proximal femur by primary ABC. We hereby present a rare case of bilateral primary ABC of the proximal femur with pathological fracture of the right femoral neck. The patient underwent right hip hemiarthroplasty and open biopsy and curettage of the left proximal femur. ABC is usually unilateral in location. Whenever there is a bilateral lesion in the proximal femur usually ABC is not suspected as a differential diagnosis, but ABC may have a bilateral presentation.

scholarly journals Repair of supracondylar femur fracture in a Lhasa Apso dog by cross pinning technique: A case report

2020 ◽  
Vol 1 (2) ◽  
pp. 140-143
Author(s):  
M. Raghunath ◽  
P. Vidya Sagar ◽  
P. Ravi Kumar ◽  
B. Sailaja ◽  
V. S. C. Bose
Keyword(s):  
Case Report ◽  
Hind Limb ◽  
Femur Fracture ◽  
Weight Bearing ◽  
Supracondylar Fracture ◽  
Implant Failure ◽  
History Of ◽  
K Wires ◽  
The Right ◽  
Radiographic Union

Abstract: A three-year-old Lhasa apso was presented with a history of fall from a height resulting in limping of the right hind limb. It was radiographically diagnosed as a complete, transverse, displaced supracondylar fracture of the femur. The fractured fragments were reduced and stabilized by cross pinning technique using k-wires, and the weight-bearing was seen from 3rd post-operative day. On the seventh post-operative day, the same animal was presented with limping on the same limb due to sudden fall from a height again. Radiographically it was confirmed as catastrophic implant failure with collapsed fragments. In surgery, the migrated pins were removed and the fragments were restabilized by cross pinning using k-wires. Post-operative application of robertjones bandage and regular physiotherapy was provided. The animal showed complete weight-bearing from 10th post-operative day, and the full radiographic union was observed on 35th post-operative day. Keywords: supracondylar fracture, k-wires, robertjones bandage, cross pinning technique

scholarly journals Diagnóstico e tratamento do plasmocitoma solitário ósseo em mandíbula / Diagnosis and treatment of solitary bone plasmacytoma in mandible

2020 ◽  
Vol 65 (1) ◽  
pp. 1
Author(s):  
Dayane Mendonça dos Santos ◽  
Claudia Rebecca Costa Cavalcante Silva ◽  
Ney Morgado Vieira Filho ◽  
Luiz Felipe Lins de Sousa Santos ◽  
Valtuir Barbosa Felix
Keyword(s):  
Multiple Myeloma ◽  
Differential Diagnosis ◽  
Clinical Characteristics ◽  
Plasma Cells ◽  
Solitary Plasmacytoma ◽  
Plasma Cell Disorders ◽  
Accurate Treatment ◽  
Solitary Bone Plasmacytoma ◽  
The Right

Introdução: O plasmocitoma solitário pertence a um conjunto de desordens de células plasmáticas. É representado por uma massa lítica que pode ser encontrada nos ossos, sendo classificado como plasmocitoma solitário ósseo. O seu diagnóstico precoce é fundamental de modo a prevenir a progressão da doença para mieloma múltiplo. Relato de caso: Paciente do sexo feminino, de raça branca, com 81 anos, diagnosticada com plasmocitoma solitário ósseo em mandíbula à direita e tratada com radioterapia de 45Gy. Resultados: Dois anos após a conclusão do tratamento, a paciente continua em acompanhamento odontológico e hematológico, não demonstrando a evidência de transformação para mieloma múltiplo. Conclusão: Devido as características clínicas inespecíficas do plasmocitoma solitário ósseo, a correta utilização dos recursos atuais disponíveis para investigação da lesão possibilita um diagnóstico diferencial, assim como um acurado tratamento e uma proservação contínua da doença.Palavras Chave: Plasmócitos, Mandíbula, Mieloma múltiploABSTRACTIntroduction: Solitary plasmacytoma belongs to a set of plasma cell disorders. It is represented by a lytic mass that can be found in the bones, being classified as solitary bone plasmacytoma. Its precocious diagnosis is essential in order to prevent the progression of the disease for multiple myeloma. Case report: Female patient, Caucasian, 81 years old, diagnosed with solitary bone plasmacytoma in the right mandible and treated with 45Gy radiotherapy. Results: Two years after completion of treatment, the patient continues in dental and hematological follow-up, showing no evidence of transformation for multiple myeloma. Conclusion: Due the not specific clinical characteristics of solitary bone plasmacytoma, the correct use of available resources for investigation of injuries enables for a differential diagnosis, as well as an accurate treatment and a continuous disease preservation.Keywords: Plasma cells, Mandible, Multiple myeloma

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